With a high number of measles outbreaks in the Lower 48 from Jan. 1 to June 6, Kenai Public Health Center Nurse Manager Charlie Barrows said Alaskans should be aware of the virus, especially during the summer travel season.

“We don’t want to frighten people, but with tourist season, people come from all over the place,” Barrows said.

While Barrows said Alaska hasn’t had a reported measles case since 2000, the state is ranked 39th for immunizations of children 19-35 months old, according to the 2011 National Immunization Survey.

“We consistently have geographic areas that are under-immunized often for religious reasons,” Barrows said. “Here, on the peninsula, we’ve got folks that … claim religious exemption. Where you have more of that religion obviously you’re going to have more kids that might be under-immunized.”

According to the Centers for Disease Control and Prevention, measles was documented as eliminated in the United States in 2000. This year the nation has seen 397 cases in 20 states and 16 outbreaks — in excess of what would be expected.

Currently, the Philippines is experiencing a large measles outbreak, and, according to the CDC, many U.S. cases have been associated with cases brought over from the Philippines.

Barrows said random measles cases are expected from unimmunized tourists. However, the nearly 400 reported cases in the nation is surprising.

The Advisory Committee on Immunization Practices recommends a two-dose schedule of the MMR — measles, mumps and rubella — vaccine. The first dose should be given when children are 12-15 months old and the second at 4-6 years old.

Barrows said under- or unimmunized children exposed to measles are at a higher risk for death from the virus.

For adults who have never been vaccinated for MMR, they are recommended to get one dose. Health-care providers and college students are recommended to get two doses, Barrows said.

Barrows said measles is a highly contagious airborne virus, and symptoms include fever, rash, runny nose and runny eyes. People who think they may have contracted measles should go to their regular medical provider, she said.

Health-care providers are encouraged to culture the rash and send it to the state laboratory, Barrows said. Measles can be misdiagnosed as scarlet fever, Kawasaki disease or dengue fever, she said.